LeadUS Mentoring Program 2015-16

Personal Information
Welcome to the LIFT2Enrich Writing Mentorship Program 2022 Application!

We are thrilled that you are interested in participating in our writing program. This program is open to ages 12 - 20. Selected mentees must be available to start and meet with their assigned mentor beginning in June, once a week for six weeks.

Please carefully read this application. Make sure the information you provide is complete and accurate. Kindly submit this form by March 30, 2022, at 11:59 pm. If you have any questions or issues, do not hesitate to reach us at info@lift2enrich.org

We will be matching our applicants with our available mentors on a first-come-first-serve basis. Mentees will be notified by April 30th.

Connect with us!
Full Name *

First Name Middle Name Last Name
Gender *

Male Female
Age *
Grade
Parent's Name 1 *
Parent's Name 2
School name *
Mobile Number 1

Area Code Phone Number
E-mail *
Current Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
List any handicaps or disabilities we should be aware of. (If selected, we will try and pair them with a special education mentor.)

Attachments
If you would like to upload a sample of your writing, please use the link below.
Sample writing 1
Sample writing 2

Submission
Questions, Comments, or Complements?
If you or someone you know is interested in becoming a mentor, please list their contact here.
Should be Empty: